Russia: HIV spreads beyond risk groups in 27 regions, epidemiologists say

In 27 Russian regions, there is a generalised HIV epidemic. This was reported by the Central Research Institute of Epidemiology of Rospotrebnadzor. Scientists use this term for the stage when the human immunodeficiency virus spreads in the general population rather than only among risk groups. ADVERTISEMENT ADVERTISEMENT In these regions, HIV is diagnosed in more than 1% of pregnant women. The situation is most serious in the Kemerovo, Irkutsk and Sverdlovsk regions. And although, according to the Central Research Institute for the Prevention and Control of AIDS, 45,000 new HIV cases were detected in Russia in 2025, which is 13.4% lower than in 2024, last year a record was set for the number of HIV and hepatitis infections in medical institutions, according to statistics compiled by the specialist portal Medvestnik. Experts record the highest level of HIV and hepatitis infections in medical facilities in 15 years These are the highest figures in the past 15 years. Clusters of viral hepatitis C and mixed HIV plus hepatitis infections predominate, said Yelena Igonina, head of the Department for the Epidemiological Wellbeing of the Population at Rospotrebnadzor. In 2025, eight clusters of infection were recorded in healthcare facilities in Russia, with 104 patients infected. According to Rospotrebnadzor, investigations continued in 2026 into 11 clusters of infection in the territory of ten regions of Russia, where the spread of HIV and hepatitis in medical organisations is suspected. In Moscow, an investigation is underway into a cluster in which 22 cases of viral hepatitis C have been identified. One of the largest confirmed clusters in the past two years was the infection of 82 people in a sanatorium in Kabardino-Balkaria. While receiving medical care, 76 patients contracted viral hepatitis C and six were found to have mixed infections. In oncology hospitals in Kamchatka Territory and Buryatia, 147 and 42 patients, respectively, were infected with hepatitis. Another three hepatitis C clusters were identified in dialysis centres in the Samara and Kursk regions, where 26 people were affected. Experts describe violations of sanitary and epidemiological rules as the main cause of the infections, including the use of single-use catheters or glucometers on several patients. In such situations, the source is usually patients with undiagnosed infections. Yelena Igonina notes that these "systemic and gross violations" have become entrenched in today’s Russia. Although simultaneous testing for hepatitis C antibodies and RNA covers blood, component, organ and tissue donors well, testing for RNA among other categories that should be tested, namely dialysis, haematology and transplant patients, contacts in hepatitis clusters, children under one born to mothers with HIV and patients with immunodeficiency, is significantly lagging behind. In addition, for the first time in six years, two cases of HIV infection via transfusion of blood components were identified in 2026, the Central Research Institute of Epidemiology of Rospotrebnadzor added. When hospitals receive large numbers of people with undiagnosed infections, international HIV consultant Aleksei Verter told Current Time, this means that "the infectious process in the country is latent, hidden" and a great many people do not know they are infected. Despite lower mortality, the number of people living with HIV is rising Despite a decline in HIV incidence and mortality in Russia in recent years, the number of people infected continues to grow, Medvestnik’s authors note. Statistics show that for each death there are one and a half new infections, that is, the number of people "living with HIV continues to grow constantly", explains Natalya Ladnaya. The decline was preceded by a long period of rising incidence, but in the past three years rates of morbidity and mortality among people with HIV have been falling and, according to her preliminary data, this trend will continue in 2026. At the same time, the expert is convinced that there is no reason to rest on one’s laurels, since "the dynamics can change rapidly". In recent years, the number of deaths from HIV in Russia has been between 30,000 and 34,000 per year. This is an extremely high figure, stresses the head of the research department for the prevention and control of AIDS at the Central Research Institute of Rospotrebnadzor. "Among all the countries in the world there are only 15 where more than 15,000 deaths of people with HIV are recorded, including Russia." "The highest HIV incidence rates per 100,000 population in the European region are in Russia, Ukraine and North Macedonia", says Central Research Institute of Epidemiology director and Rospotrebnadzor academician Vasily Akimkin. HIV infection has become the leading cause of death among Russians of working age. Among men aged 40 to 49, more than 3% are affected by the virus, clarifies Natalya Ladnaya, while the average age of those infected in Russia has increased over the past 15 years from 32 to 44. It is also noteworthy that two-thirds of new HIV transmissions occur through heterosexual contact. More than 1.232 million people with a confirmed HIV diagnosis now live in Russia, which is 0.8% of the country’s population, Akimkin adds. Rospotrebnadzor has warned that if current approaches to prevention and treatment remain unchanged, the number of people living with HIV in Russia could reach 1.47 million by 2030, according to the agency’s mathematical model. Under this scenario, the annual number of new cases will be between 31,000 and 51,000, and the number of deaths included in the model could rise to 51,000 a year, which is linked, among other things, to population ageing. In the past seven years, the main causes of death among children with HIV have also changed. An increase in mortality in this group of patients was recorded in 2025 in all federal districts except the Central and Ural districts. According to an analysis by several Russian media outlets, Rospotrebnadzor and the Health Ministry calculate figures differently. Rospotrebnadzor’s data are more complete, as they are based on laboratory notifications of every positive immunoblot. The Health Ministry’s data are based on the number of people who have been registered for regular follow-up care. As a result, the overall gap between the total number of people with a confirmed diagnosis, 1.23 million according to Rospotrebnadzor, and those actually under medical supervision, 846,500 according to the Health Ministry, amounts to 385,555 people. 600,000 infected people Only half of people living with HIV in Russia had a suppressed viral load by the end of 2025, said Natalya Ladnaya at the conference "Epidemiological Surveillance of HIV Infection", as quoted by Medvestnik. In practice, this means that at least 600,000 people with HIV "continue to play an active part in transmitting the virus", the expert concludes. Viral load suppression occurred last year in 77.9% of people with HIV who were receiving antiretroviral therapy (ART), and "so far it has not been possible to exceed this level", she says, while WHO standards for keeping the epidemic under control are 95-95-95, that is, 95% of people with HIV know their status, 95% of them receive ART and 95% of those on therapy achieve suppression of HIV replication. As for access to medical care for people living with HIV in Russia, 72% of those infected were under follow-up last year. Despite extensive HIV testing, which has increased by 75% over the past decade and reached 54 million tests last year, effectiveness is declining. In the view of the director of the Central Research Institute of Epidemiology of Rospotrebnadzor, approaches need to be adjusted by increasing the share of people at the highest risk of infection, who are insufficiently covered by testing. Their share has now almost halved, from 5.8% in 2014 to 3% in 2023. But the effectiveness of the work is declining, meaning there are more tests, but testing is increasingly carried out among people with a lower probability of having HIV. Chronic underfunding by the state The fact that the burden of HIV infection is not decreasing even as incidence falls is reflected in healthcare spending, stresses Natalya Ladnaya. In 2025, spending related to HIV infection was estimated at 279 billion roubles. In the expert’s view, there is no reason to expect the situation to change; on the contrary, the spread of the virus may intensify among traditionally vulnerable population groups and among people living in regions bordering Ukraine that are characterised by high levels of migration. According to Rospotrebnadzor, incidence and mortality may also rise in the Far Eastern, Southern and North Caucasian federal districts. Bloggers have also spoken about the spread of viruses, including HIV, among those fighting against Ukraine. According to Anastasia Kashevarova, the Russian authorities should "seriously think about it, there is a threat of an epidemic of socially dangerous diseases", since hepatitis, HIV and tuberculosis are currently spreading in the army and to frontline regions, but "will then spread further into the interior of Russia". The Insider previously reported that after Russia’s occupation of parts of Donetsk and Luhansk regions, patients with HIV faced shortages of life-saving medicines. The Russian Health Ministry did not include them in centralised drug procurement, and some patients were given medicines past their expiry date. According to observers, the fact that the healthcare budget is shrinking and all funds are going to the war helps explain, among other things, shortages of sterile consumables in state hospitals. Other Russian media emphasise that most donors financing HIV prevention programmes for the general population and vulnerable groups have left Russia. The country itself does not adequately fund these projects, says Evgeny Pisemsky, editor-in-chief of the queer media outlet "Parni+", quoted by Current Time. With 45,000 new HIV cases detected in 2025, the draft Russian budget for 2027 provides for additional funding for medicines for only 30,000 new carriers of the virus.